Prediction of outcome of surgery and anesthesia in patients over 80

Abstract

The outcome of surgery in 500 patients over 80 yr of age was studied. Hospital mortality within 1 mo. of surgery was 6.2%. The American Society of Anesthesiologists class 1 to 5 preoperative evaluation scale was useful in predicting death-less than 1% of class 2 patients died, 4% of class 3 and 25% of class 4. Six of 7 perioperative deaths were caused by mesenteric infarction. Myocardial infarction was the leading cause of postoperative death. Twenty-four percent of 141 patients who underwent upper abdominal surgery required controlled endotracheal ventilation for more than 24 h postoperatively; 57% after intrathoracic surgery; and only 2% after surgery that did not enter pleura or peritoneum. Forty-seven patients underwent gallbladder surgery and 27 peripheral underwent vascular surgery without any hospital fatality. Enflurane appears to be a safe general anesthetic for sick, elderly patients.